PURPOSE: To study whether preoperative fasting would influence postoperative prognosis and to measure the variation of the ketone body amount and ketone body ratio, kidney function during the postoperative period in the model of 90% hepatectomy. MATERIALS AND METHODS: Total of 180, seven weeks old, male, specific pathogen free Sprague-Dawley rats, divided into two groups of the fasted and the fed. First, 80 rats were divided into two groups of 40 each; 40 of that were denied food for 48 hours before the operation, other 40 were fed. Following 90% hepatectomy they were investigated by Kaplan-Meier method, drawing a survival curve. Secondly, 100 rats were divided into two groups of 50 each, 50 of that were denied food for 48 hours before the operation, and the other 50 were fed. Following 90% hepatectomy, they were investigated by the method of Student's T-test and Mann-Whitney test on the following: the amount of arterial ketone body in the blood in the blood sampled from abdominal aorta, reading at preoperative 48 hours, at the time of operation, postoperative 6 hours, 12 hours, 24 hours, 48 hours periods. RESULTS: The mean survival time after operation: the fasted group was 53.0+/-3.7 hours and the fed group was 34+/-1.7 hours and it had the statistical significance(p=0.0008). Rats which had long term survival over 72 hours were 14(35%) in fasted group, but only 2(5%) in fed group. In preoperative fasted group arterial ketone body ratio was recovered earlier than fed group and ketone body amount elevated, but in preoperative fed group, there was no significant change in ketone body amount. Blood glucose level lowered in both groups. Blood ammonia was severely increased in preoperative fed group, suggested bad liver function and destruction of muscle. BUN and blood creatinine was elevated in preoperative fed group, suggested lowered kidney function. CONCLUSION: Preoperative fasting has a positive influence on survival of the rats which has acute liver failure induced by 90% hepatectomy, because it could be caused by increased ketone body amount by preoperative fasting.
Ammonia ; Animals ; Aorta, Abdominal ; Blood Glucose ; Creatinine ; Fasting* ; Hepatectomy* ; Humans ; Kidney ; Liver ; Liver Failure ; Liver Failure, Acute ; Male ; Postoperative Period ; Prognosis ; Rats* ; Rats, Sprague-Dawley ; Specific Pathogen-Free Organisms ; Survival Rate

Nasal dermoid sinus cysts are the most common congenital midline nasal lesion, accounting for 1% to 3% of all dermoid cysts, and 4% to 12% of all head and neck dermoids. Selection of the appropriate reconstruction technique, after dermoid resection, is important for treatment. Here we describe the successful management of a case with a nasal dermoid sinus cyst using an open rhinoplasty approach, and primary reconstruction using Tutoplast-processed fascia lata and crushed septal cartilage.
Accounting ; Cartilage ; Dermoid Cyst ; Fascia ; Fascia Lata ; Head ; Neck ; Rhinoplasty

BACKGROUND AND OBJECTIVES: Human rhinovirus (HRV) infection is the primary cause of the common cold. It was often reported that the frequency of viral rhinitis is higher among patients with chronic rhinosinusitis with nasal polyposis (CRS/ NP) than normal subjects. And, patients with nasal polyps often complain that they suffer from a relatively severe degree of URI. The purpose of this article was to evaluate whether the HRV infection rate and virus-induced cytokine secretion is different between the organ culture model of the nasal polyp mucosae and the sinus mcuosae. MATERIALS AND METHODS: Organ cultures of nasal polyps from sixteen CRS/NP patients and normal sphenoid sinus mucosae from nineteen patients who underwent the trans-sphenoidal pituitary surgery were tested. The successful viral infection by HRV-16 was determined by seminested reverse transcription-PCR. Immunoreactive IL-6 and IL-8 were quantitated using the ELISA. RESULTS: A PCR product indicating the successful RV infection was detected in nine of sixteen (56.3%) polyp samples and eleven of nineteen (57.9%) normal sphenoid sinus samples were tested positive for HRV-16. Rhinovirus infection increased the IL-6 and IL-8 secretion to 236% and 173% in polyp samples and to 231% and 145% in sphenoid mucosa samples respectively. However, there was no significant difference in rhinovirus infection rate and in the rhinovirus-induced IL-6 and IL-8 secretion between the groups. CONCLUSION: The results of this study may suggest that the nasal polyp mucosae, when compared with normal sinus mucosae, did not show more vulnerability to HRV infection nor more intense cytokine response by HRV infection.
Common Cold ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6 ; Interleukin-8 ; Mucous Membrane* ; Nasal Polyps* ; Organ Culture Techniques* ; Polymerase Chain Reaction ; Polyps ; Rhinitis ; Rhinovirus* ; Sphenoid Sinus*

BACKGROUND AND OBJECTIVES: Continuous Positive Airway Pressure (CPAP) is generally effective in correcting sleep-related respiratory disturbance in Obstructive Sleep Apnea Syndrome (OSAS). But the failure to comply with this treatment poses a serious limitation to its use. The aim of this study is to investigate the state of compliance and the cause of noncompliance of auto-adjusting positive airway pressure (autoPAP) treatment in Korean OSAS patients. MATERIALS AND METHODS: This study performed a survey of 45 patients who had selected the autoPAP treatment between August 2000 and May 2003. RESULTS: Twelve of the 45 patients (26.7%) refused the autoPAP treatment immediately after the first trial due to claustrophobia. Also, twenty patients (44.4%) stopped using it within 1 month. Only 13 patients (28.9%) continued to use it for more than 1 month. Twenty seven of the 33 patients (81.8%) who had used the autoPAP complained of claustrophobia after the first trial. The major factors of low compliance were claustrophobia, restricted body position while asleep, nasal symptoms, high cost, and inadequate education of patients. CONCLUSION: This study shows that claustrophobia is a major cause for the noncompliance of autoPAP. It also shows that the patients are encouraged by the effectiveness of the autoPAP to use it for a longer period. Therefore, we should focus on explaining the effects and drawbacks of autoPAP, desensitization and behavioral modification.
Compliance* ; Continuous Positive Airway Pressure ; Humans ; Patient Education as Topic ; Phobic Disorders ; Sleep Apnea, Obstructive*

BACKGROUND AND OBJECTIVES: It has been known that MMP-9, TIMP-1, and VEGF play an important role in the formation of nasal polyps (NPs). The aim of this study is to investigate the effect of smoking on the expression of MMP-9, TIMP-1 and VEGF in the epithelial cells and fibroblasts of NPs. MATERIALS AND METHODS: The epithelial cells and fibroblasts of NPs obtained from 10 patients who underwent endoscopic sinus surgery were cultured and used. The prepared CSE concentrations were 5%, 1%, 0.5% and 0.1%. In the control group, cells were cultured for 9 hours in the media containing 1 ml of AEGM and DMEM/F-12K. In the CSE group, cells were treated with 5%, 1%, 0.5% and 0.1% CSE for 9 hours. After washing with PBS, cells were cultured in medium for 24 hours. ELISA was performed to measure the secretion of MMP-9, TIMP-1 and VEGF proteins and real-time PCR was performed to assay their mRNAs. RESULTS: The production of MMP-9, TIMP-1 and VEGF proteins did not change significantly in comparison with the control group in epithelial cells and fibroblasts after exposure to CSE. CONCLUSION: These results suggest that CSE does not appear to have an effect on the expression of MMP-9, TIMP-1 and VEGF for developing and growth of nasal polyposis.
Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Fibroblasts ; Humans ; Nasal Polyps ; Proteins ; Real-Time Polymerase Chain Reaction ; Smoke ; Smoking ; Tissue Inhibitor of Metalloproteinase-1 ; Tobacco Products ; Vascular Endothelial Growth Factor A

BACKGROUND AND OBJECTIVES: Antrochoanal polyp (ACP) is a benign maxillary sinus polyp that originates from the mucosa of the maxillary sinus, passes through the sinus ostium, and extends into the choana. Surgical methods employed in the treatment of antrochoanal polyp are simple avulsion, Caldwell-Luc operation, osteoplastic maxillary sinus operation, and endonasal endoscopic removal. In this study, we evaluated the clinical presentation of ACP and compared its surgical outcomes. MATERIALS AND METHODS: We retrospectively reviewed 111 patients who were treated for ACP between January 1995 and May 2008, and analyzed clinical features, radiologic findings, and surgical results. RESULTS: The study group consisted of 111 patients (65 males, 46 females) with a mean age of 20.0 years (range, 4 to 70). Sixty-one cases were accompanied by sinusitis (20 with unilateral sinusitis, 41 with bilateral sinusitis). Endoscopic sinus surgery (ESS) was used to treat 95 cases, and the external approaches of Caldwell-Luc operation or osteoplastic maxillary sinus operation were applied in 12 and four cases, respectively. Among those who received ESS, ACP recurred in 16 cases, whereas none of the patients who received the external approach showed recurrence. CONCLUSION: Endoscopic sinus surgery is a good alternative method for the treatment of ACP. If the antral part of ACP cannot be removed completely, an external approach such as Caldwell-Luc operation or osteoplastic maxillary sinus operation for pediatric patients may be considered to prevent recurrence.
Carbamates ; Humans ; Male ; Maxillary Sinus ; Mucous Membrane ; Organometallic Compounds ; Polyps ; Recurrence ; Retrospective Studies ; Sinusitis

Purpose: The goal of this study is to define whether or not preoperative portal vein embolization has any additional role in the total amounts of liver regeneration and functional improvement after major hepatectomy in rat model. In addition, this study is to define obstructive jaundice has any positive or negative effect on it. METHODS: There were a total of 650 rats, divided into three experimental groups. Experiment A was done under the normal liver status, experiment B was done under the obstructive jaundice status, experiment C was done under the external biliary drainaged status. Each experimental group was divided into three groups that had been made by different surgery. One was 70% partial hepatectomy, another was 70% portal vein branch ligation, and the other was 70% portal vein ligation followed by 70% hepatectomy. Each operational group required over 60 rats for serial data collection which was taken at the operation and 6, 12, 24, 48, 72 hours after operation. RESULTS: We finally observed that there was no additional regeneration of remaining liver by doing preoperative portal vein embolization. It was same in obstructive jaundice group and external biliary drainaged group. And also, there was no significant fucntional improvement or deterioration by existence of obstructive jaundice. Conclusion: We conclude it is no worth doing preoperative portal vein embolization for getting additional liver regeneration and obstructive jaundice does not has significant positive or negative effect on liver regeneration and hepatic function in itself.
Animals ; Data Collection ; Hepatectomy ; Jaundice* ; Jaundice, Obstructive ; Ligation* ; Liver Regeneration ; Liver* ; Models, Animal ; Portal Vein* ; Rats* ; Regeneration*

BACKGROUND AND OBJECTIVES: Sinonasal sarcomas are relatively rare tumors, accounting for only about 1 percent of all sinonasal malignancies. The purpose of this study is to analyze the clinical features, treatment modalities and outcomes, survival and prognostic factors of sinonasal sarcomas. SUBJECTS AND METHOD: We retrospectively reviewed the medical records of 20 patients who were diagnosed and treated for sinonasal sarcomas between July 1993 and June 2006. Potential prognostic factors including age, tumor size, histology and adjuvant treatment were evaluated. RESULTS: According to histologic subtype, twenty cases consisted of 7 rhabdomyosarcomas, each 2 cases of spindle cell sarcoma, Ewing's sarcoma, angiosarcoma, and each 1 case of fibrosarcoma, leiomyosarcoma, hemangiopericytoma, peripheral neuroectodermal tumor, myxoid sarcoma, osteosarcoma, chondrosarcoma. The mean follow-up period was 61 months. Fourteen patients (65%) had undergone surgical approach with adjuvant chemotherapy or radiotherapy. Four patients (20%) had undergone surgical treatment only. Two patients (15%) had undergone chemotherapy or radiotherapy. At 5 years, the overall survival rates of sinonasal sarcomas were 65%. The survival rates according to the treatment modality were 100% (surgery only), 66% (surgery with adjuvant chemotherapy or radiotherapy), and 33% (chemotherapy or radiotherapy), respectively. The overall recurrence rates of the sinonasal sarcomas were 25%. The univariate analysis showed that the treatment modality and surgical margin are important prognostic factors for survival. CONCLUSION: The 5-year survival rate of sinonasal sarcomas was 65%. Early diagnosis and wide excision with safe resection margin are important for the treatment of sinonasal sarcomas.
Accounting ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Early Diagnosis ; Fibrosarcoma ; Follow-Up Studies ; Hemangiopericytoma ; Hemangiosarcoma ; Humans ; Leiomyosarcoma ; Medical Records ; Neuroectodermal Tumors, Primitive, Peripheral ; Osteosarcoma ; Recurrence ; Retrospective Studies ; Rhabdomyosarcoma ; Sarcoma ; Sarcoma, Ewing ; Survival Rate

BACKGROUND AND OBJECTIVES : The toxins generated from Staphylococcus aureus, Staphylococcal enterotoxin A (SEA) and B (SEB), are reported to have an important role in the pathogenesis of chronic rhinosinusitis. As a basic step for elucidating the pathophysiologic responses of the nasal mucosa of chronic rhinosinusitis associated with rhinovirus infection, this study investigated the effect of SEA and SEB on rhinovirus infection in A549 cells. MATERIALS AND METHOD : The effect of SEA and SEB on the rhinovirus-induced changes in intercellular adhesion molecule-1 (ICAM-1) expression was assessed by flow cytometry. The effect of staphylococcal toxins on the rhinovirus-induced cytokine secretion was measured by ELISA. The effect of the replication of rhinovirus in the cells was examined by viral culture with subsequent determination of viral titer. RESULTS : ICAM-1 expression was increased in the rhinovirus infection group. Cytokine secretion was also increased in the rhinovirus infection group. But there was no additional increase due to staphylococcal toxins regarding the ICAM-1 expression and cytokine secretions. Staphylococcal toxins increased viral titer in proportion to toxin concentrations. CONCLUSION : SEA and SEB increased rhinoviral replication in airway epithelial cells. This result shows that airway epithelial cells with chronic rhinosinusitis are more favorable environments for rhinovirus infection.
Enterotoxins* ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Flow Cytometry ; Intercellular Adhesion Molecule-1 ; Nasal Mucosa ; Rhinovirus* ; Staphylococcus aureus

Leiomyosarcoma is a malignant mesenchymal tumor that is relatively common in the uterus, the gastrointestinal tract, and the retroperitoneum. Only 3 to 10% of leiomyosarcomas arise in the head and neck. A review of the English-language literature since 1908 revealed 11 cases of primary and one case of metastatic leiomyosarcoma of the gingiva. We report on a case of leiomyosarcoma that arose in a 34-year old male, affecting the mandibular gingiva.
Adult ; Gastrointestinal Tract ; Gingiva* ; Head ; Humans ; Leiomyosarcoma* ; Male ; Neck ; Uterus